Vigilance is needed with medication, even common ones

Drugs are prescribed to correct imbalances, but often they trigger other imbalances.

A recent American study using 10 years of survey data from a big national sample of over 26,000 people (all ages, male and female) reported that 37% were taking medications that have depression as a potential side-effect.

These included proton pump inhibitors (PPIs) prescribed for reflux; beta-blockers for high blood pressure; the Pill; steroid medication for asthma, auto-immune and inflammatory conditions; and prescription-strength ibuprofen.

Of the people who weren’t taking any of these, the prevalence of depression was just under 5%. Of those taking one of them, it was about 7%. And for people taking three or more, it was 15%.

This kind of study doesn’t prove that those medications cause depression — it only shows an association between the two — but there’s a trend worth noticing.

In Australia the 10 most prescribed medications in 2015 (the most recent figures we have) were headed by two statins, followed by a PPI (Nexium). The rest of the list comprised Paracetamol, another PPI, a blood pressure medication (not a beta-blocker), Metformin (for diabetics) and three antibiotics.

In 2013-2014, over 19 million prescriptions were written for PPIs, and that’s unlikely to have fallen. That’s a lot of upset guts.

Conditions such as reflux or high blood pressure ought to be seen as red flags telling us to shift our lifestyle. Even if we need medication, taking steps to improve our health makes an important difference.

In the case of reflux, a short dose of a PPI might be useful, along with steps such as dietary changes or stress management.

The real issue with many medications is long-term use.

In light of research that has linked PPIs to a range of health problems (including stroke and fractures as well as depression), the national Gastroenterological Society is encouraging GPs to manage patients off them, or at least down to the lowest dose.